Climate Analysis-18th Century North America (New York-New Jersey Campaign 1776-1777)
The following post has two assignments namely;
1.Climate Analysis-18th Century North America (New York-New Jersey Campaign 1776-1777)
Investigate climate in the eighteenth century – specifically, during the era of the Revolutionary War (1770-1790). Was it unusually cold, or was Washington just unprepared (and without central
heat)? How did people think about climate and weather? How did they respond and adapt? What can this tell us about climate and climate change today?
draw upon at least five scholarly sources (books or articles). Use the library catalogue and the database America History and Life.
explain your research process, question, and rationale; discuss the nature of your sources; reflect on any particular challenges;
speak to the historical significance of your findings; – comment on any relevance to larger discussions of climate in American history
How did weather effect the New York-New Jersey Campaign (1776-1777)? (specifically looking at the Battle of Trenton, Battle of Long Island, one or 2 other battles) ?-
2.Family Nurse Practitioner in the outpatient setting.
Ms. Flowers is a 24-year-old woman who presents to the emergency department with a 24-hour history of acute vaginal bleeding associated with severe, crampy, constant left pelvic pain exacerbated by
movement. She is sexually active, uses condoms inconsistently and uncertain of her last menstrual period. She has none of her usual perimenstrual symptoms; the amount of bleeding is similar to a
heavy period. She is G0P0; history of chlamydial cervicitis 3 years ago; no prior PID or IUD use; ruptured appendix (age 16). Physical exam is significant for tachycardia, LLQ tenderness with
guarding, and absence of rebound tenderness.
DDX: Tubo ovarian abscess vs ovarian cyst vs ovarian torsion vs ectopic pregnancy vs abortion vs PID vs endometriosis vs dysmenorrhea
LABS and TEST: CBC, type and cross, progesterone, UA, HCG, LFT, obstetric ultrasound
Abnormal: highly probable left fallopian tube ectopic pregnancy
A serum progesterone level <5 ng/dl is indicative of non viable pregnancy
Elevated HCG value is consistent with a 5-6 week gestation
Diagnosis : Ectopic pregnancy
Ms. Flowers presents with the classic clinical triad of ectopic pregnancy. Amenorrhea, LLQ pain and abnormal vaginal bleeding.
Discuss the questions that would be important to include when interviewing a patient with this issue. Describe the clinical findings that may be present in a patient with this issue. Are there any
diagnostic studies that should be ordered on this patient? Why? List the primary diagnosis and three differential diagnoses for this patient. Explain your reasoning for each. Discuss your
management plan for this patient, including pharmacologic therapies, tests, patient education, referrals, and follow-ups.